Differentiated cost shares for drugs and medicinal products

The cost share (copayment) for drugs is essentially 10 per cent of the costs in excess of the annual deductible. If the specialities list contains more than one drug with the same active ingredient or ingredients, the copayment can be up to 20 per cent.

A higher cost share can apply if the patent of a drug has expired and generics are available and contained in the
specialities list. A higher cost share can apply to original preparations, co-marketed drugs and generics.

The copayment for drugs whose ex-factory price exceeds a specific limit is increased to 20 per cent of the costs in excess of the annual deductible.

Drugs subject to a higher copayment are marked with an X on a red background in the “SB” column of the electronic specialities list (available at www.spezialitaetenliste.ch).

Physicians and chiropractors must inform the patient if the specialities list contains one or more generics that can be substituted for an original preparation.

The limit described above is calculated by adding 10 per cent to the average ex-factory price of the cheapest one third of all drugs on the specialities list with the same active ingredient composition. These limits are fixed by the FOPH on 1 December every year, or when the first generic is added to the specialities list. The limits listed below apply from 1 December 2021. The information provided on certain packages on the higher cost share may be obsolete; the information contained on the specialities list is binding.

Limits applicable from 1 December 2022

The limits listed below apply from 1 December 2022. The factory prices are based on the SL data base of 1 August 2022. The information provided on certain packages on the higher cost share may therefore be obsolete; the information contained on the specialities list is always binding for the currently valid cost share.